[1]左　乔　许　奕　洪　波　刘建民　黄清海.新型机械解脱弹簧圈栓塞颅内动脉瘤的初步经验[J].中国临床神经外科杂志,2017,(03):165-167,200.[doi:10.13798/j.issn.1009-153X.2017.03.013]
　ZUO Qiao,XU Yi,HONG Bo,et al.Initial experience in embolizing intracranial aneurysms with new mechanical detachable coils (Presgo?)[J].,2017,(03):165-167,200.[doi:10.13798/j.issn.1009-153X.2017.03.013]
点击复制

新型机械解脱弹簧圈栓塞颅内动脉瘤的初步经验()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2017年03期
页码:
165-167,200
栏目:
论著
出版日期:
2017-03-20

文章信息/Info

Title:
Initial experience in embolizing intracranial aneurysms with new mechanical detachable coils (Presgo?)
文章编号:
1009-153X（2017）03-0165-03
作者:
左　乔　许　奕　洪　波　刘建民　黄清海
200433上海，第二军医大学附属长海医院神经外科
Author(s):
ZUO Qiao;  XU Yi;  HONG Bo;  LIU Jian-min;  HUANGQing-hai.
Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
关键词:
颅内动脉瘤; 栓塞治疗; Presgo?机械解脱弹簧圈; Jasper电解脱弹簧圈; 安全性; 有效性
Keywords:
Intracranial aneurysms;  Endovascular embolization;  Mechanical detachable Coil;  Safety;  Efficacy
分类号:
R 743.9; R 815.2
DOI:
10.13798/j.issn.1009-153X.2017.03.013
文献标志码:
A
摘要:
目的 初步评价使用国产Presgo?机械解脱弹簧圈栓塞颅内动脉瘤的安全性和有效性。方法 2011年8月至2012年9月前瞻性收治颅内动脉瘤15例，根据患者意愿分为观察组（7例，7个动脉瘤）和对照组（8例，9个动脉瘤）；观察组使用Presgo?机械解脱弹簧圈，对照组使用国产Jasper电解脱弹簧圈。观察组随访169~934 d，中位随访时间为303 d；对照组随访91~411 d，中位随访时间为235 d。结果 两组弹簧圈填塞技术成功率均为100%；观察组弹簧圈解脱时间[5.0 s（5.0~8.0 s）]较对照组[45.0 s（38.0~47.3 s）]显著缩短（P<0.05）。观察组术后即刻Raymond Ⅰ级栓塞2个，Ⅲ级栓塞5个；对照组Ⅱ级栓塞3个，Ⅲ级6个；两组无明显差别（P>0.05）。观察组发生手术相关不良事件2例，对照组为1例；两组差异无统计学意义（P>0.05）。术后6个月，观察组mRS评分0~1分6例，对照组为8例；两组无统计学差异（P>0.05）。结论 相比国产Jasper电解脱弹簧圈，新型国产Presgo?机械解脱弹簧圈具有更好的解脱性能，其安全性和有效性与Jasper弹簧圈相仿；但本研究临床样本量小，Presgo?弹簧圈临床使用的安全性和有效性尚需进一步大样本临床验证和长期随访评价。
Abstract:
Objective To analyze the safety of domestic-made Presgo? mechanical detachable coil and its curative effect on intracranial aneurysms. Methods Of 16 patients with intracranial aneurysms, 7 received endovascular embolization of the aneurysms with Presgo? coils and 9 with domestic-made Jasper electronic detachable coils from August, 2011 to September, 2012 in the single center. The detachment function, embolization result, the rate of procedure-related adverse event occurrence rate and modified Rankin Scale (mRS) scores were compared between the two groups. Results The success rates of embolization with two types of coils were both 100%; The median detachment time of Presgo? coil was 5.0 s, which was significantly shorter than that of Jasper coil (45.0 s, P<0.001). There was insignificant difference in the curative effects on the aneurysms between the two groups 6 months after the embolization (P=0.649). No aneurysms recurred in both the groups. There were insignificant differences in the occurrence rates of the procedure-related adverse events and the prognoses between both the groups (P>0.05). Conclusions Presgo? mechanical detachable coil can be detached more quickly compared to Jasper electronic detachable coil. Presgo? mechanical detachable coil is similar to Jasper electronic detachable coil in the safety and occluding effect on the aneurysms. But the sample size in this study is very small, and it is necessary to for the clinical safety and efficacy of Presgo? coils be studied further with larger samples and long-term follow-up.

参考文献/References:

[1] Dovey Z, Misra M, Thornton J, et al. Guglielmi detachable coiling for intracranial aneurysms: the story so far [J]. Arch Neurol, 2001, 58(4): 559-564.
[2] Vanlandingham M, Fox B, Hoit D, et al. Endovascular treatment of intracranial dural arteriovenous fistulas [J]. Neurosurgery, 2014, 74 Suppl 1: S42-49.
[3] Ellis JA, Lavine SD. Role of embolization for cerebral arte- riovenous malformations [J]. Methodist Debakey Cardiovasc J, 2014, 10(4): 234-239.
[4] Griessenauer CJ, Foreman P, Deveikis JP, et al. Endovascu- lar tools available for the treatment of cerebrovascular disease [J]. Neurosurg Clin N Am, 2014, 25(3): 387-394.
[5] 张鸿祺，杨新健，黄清海，等. Jasper电解可脱性弹簧圈治 疗颅内动脉瘤的多中心临床试验研究[J]. 中国脑血管病 杂志，2008，5（10）：446-450.
[6] Ren H, Wei M, Yin L, et al. Endovascular coiling of small intracranial aneurysms using a very soft bare platinum coil: A comparison of the packing performance of new and old HyperSoft(R) helical coils [J]. Interv Neuroradiol, 2016, 22 (1): 26-33.
[7] Raymond J, Guilbert F, Weill A, et al. Long-term angiogra- phic recurrences after selective endovascular treatment of aneurysms with detachable coils [J]. Stroke, 2003, 34(6): 1398-1403.
[8] 黄清海，吕　楠. 颅内动脉瘤血管内治疗结果的评估—标 准化报告的必要性[J]. 中国脑血管病杂志，2013，10（2）： 57-59.
[9] Morita A, Kirino T, Hashi K, et al. The natural course of unruptured cerebral aneurysms in a Japanese cohort [J]. N Engl J Med, 2012, 366(26): 2474-2782.
[10] 王　驰，曹伟，左　乔，等. 颅内动脉瘤血管内栓塞术后复 发的影响因素分析[J]. 中国脑血管病杂志，2016，13（3）： 113-117.
[11] 中华医学会神经外科学分会神经介入学组. 颅内动脉瘤 血管内介入治疗中国专家共识（2013）[J]. 中国脑血管病 杂志，2013，10（11）：606-616.
[12] Connolly ES Jr., Rabinstein AA, Carhuapoma JR, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhage: a guideline for healthcare professionals from the American Heart Association/american Stroke Associa- tion [J]. Stroke, 2012, 43(6): 1711-1737.
[13] Thompson BG, Brown RD Jr., Amin-Hanjani S, et al. Guidelines for the management of patients with unruptured intracranial aneurysms: a guideline for healthcare professio- nals from the american heart association/american stroke association [J]. Stroke, 2015, 46(8): 2368-2400.
[14] 吴中学，孙永权，王忠诚，等. 国产电可解脱性微弹簧圈的 初步临床应用[J]. 中华神经外科杂志，2000，16（1）：35- 37.
[15] 姜　鹏，穆士卿，张友平，等. 国产电解可脱弹簧圈的初步 临床应用[J]. 中华神经外科杂志，2011，27（7）：656-659.

相似文献/References:

[1]曾　春　张施远　蒋永明.复合手术与常规夹闭术治疗颈内动脉后交通动脉破裂动脉瘤的疗效对比研究[J].中国临床神经外科杂志,2016,(05):257.[doi:10.13798/j.issn.1009-153X.2016.05.001]
　ZENG Chun,ZHANG Shi-yuan,JIANG Yong-ming.Analysis of the effects of hybrid surgery on posterior communicating artery aneurysms: a comparison with conventional craniotomy[J].,2016,(03):257.[doi:10.13798/j.issn.1009-153X.2016.05.001]
[2]周有东　敖祥生　刘汉东　王志勇　朱耀祖　周达全.支架辅助弹簧圈和单纯弹簧圈栓塞治疗颅内动脉瘤疗效及安全性的Meta分析[J].中国临床神经外科杂志,2016,(05):274.[doi:10.13798/j.issn.1009-153X.2016.05.006]
　ZHOU You-dong,AO Xiang-sheng,LIU Han-dong,et al.A mata-analysis of curative effects of stent-assisted coiling and simple coiling on intracranial aneurysms and their safety[J].,2016,(03):274.[doi:10.13798/j.issn.1009-153X.2016.05.006]
[3]赵　平　王雄伟　汪　雷　马金阳.显微手术和血管内栓塞术治疗颅内动脉瘤的疗效分析[J].中国临床神经外科杂志,2016,(05):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]
　ZHAO Ping,WANG Xiong-wei,WANG Lei,et al.Effect of endovascular treatment on intracranial aneurysms: a comparison with microsurgery[J].,2016,(03):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]
[4]李朝晖　王玉贵　张孟超 综述　赵兴利 审校.CT灌注成像在动脉瘤性蛛网膜下腔出血中的 临床应用进展[J].中国临床神经外科杂志,2016,(05):313.[doi:10.13798/j.issn.1009-153X.2016.05.021]
[5]刘福德　邓剑平　张　涛　陈　虎　李　帅　王俭博　曲友直　赵振伟.椎-基底动脉夹层动脉瘤的血管内治疗（附48例分析）[J].中国临床神经外科杂志,2016,(06):353.[doi:10.13798/j.issn.1009-153X.2016.06.011]
　LIU Fu-de,DENG Jian-ping,ZHANG Tao,et al.Endovascular treatment of vertebrobasilar artery dissecting aneurysms (report of 48 cases)[J].,2016,(03):353.[doi:10.13798/j.issn.1009-153X.2016.06.011]
[6]吴有志　罗良生　张　健　陈　骅　吴　鸣　刘　振　史　岩.前循环破裂动脉瘤伴脑内血肿的 早期显微手术治疗[J].中国临床神经外科杂志,2016,(06):376.[doi:10.13798/j.issn.1009-153X.2016.06.020]
[7]潘　力　刘　鹏　秦　杰　杨　柳　安学峰　吴　虓　杨　铭　徐国政　马廉亭.Y型支架辅助技术在颅内动脉分叉部宽颈动脉瘤治疗中的应用[J].中国临床神经外科杂志,2016,(07):394.[doi:10.13798/j.issn.1009-153X.2016.07.002]
　PAN Li,LIU Peng,QIN Jie,et al.Application of Y -configuration stent technique to treatment of intracranial wide-neck bifurcation aneurysms[J].,2016,(03):394.[doi:10.13798/j.issn.1009-153X.2016.07.002]
[8]周　量　刘　丛　张昌伟.早期栓塞术治疗动脉瘤性蛛网膜下腔出血的疗效[J].中国临床神经外科杂志,2016,(07):410.[doi:10.13798/j.issn.1009-153X.2016.07.007]
　ZHOU Liang,LIU Cong,ZHANG Chang-wei..Curative effect of early endovascular embolization on patients with ruptured intracranial aneurysms[J].,2016,(03):410.[doi:10.13798/j.issn.1009-153X.2016.07.007]
[9]张　莹　荆林凯　张倩倩　刘　健　张义森　王　坤　穆士卿　杨新健.颈内动脉后交通动脉小动脉瘤破裂危险因素分析[J].中国临床神经外科杂志,2016,(03):138.[doi:10.13798/j.issn.1009-153X.2016.03.002]
　ZHANG Ying,JING Lin-kai,ZHANG Qian-qian,et al.Analysis of risk factors related to rupture of small (diameter ≤5 mm) posterior communicating artery aneurysms[J].,2016,(03):138.[doi:10.13798/j.issn.1009-153X.2016.03.002]
[10]朱作磊 综述　罗良生 审校.动脉瘤性蛛网膜下腔出血的预后相关因素研究进展[J].中国临床神经外科杂志,2016,(03):183.[doi:10.13798/j.issn.1009-153X.2016.03.020]
[11]刘 泉,李 俊.左侧小脑后下动脉远端动脉瘤栓塞术中破裂抢救成功1例[J].中国临床神经外科杂志,2019,(06):382.[doi:10.13798/j.issn.1009-153X.2019.06.022]

备注/Memo

备注/Memo:
基金项目：国家重点研发项目（2016YFC1300700）；上海市科委“科技创新行动”产学研医（13DZ1941300）；上海市科委“科技创新行动”科技支撑（12441900800）
通讯作者：黄清海，E-mail：ocinhqh@163.com
更新日期/Last Update: 2017-03-25